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OBJECTIVE@#To rapidly identify the two morphologies and chemical properties of similar herbal medicines, Blumea riparia and B. megacephala as the basis for chemical constituent analysis.@*METHODS@#UPLC-Q-Exactive-MS/MS was utilized for profiling and identification of the constituents in B. riparia and B. megacephala. Chemical pattern recognition (CPR) was further used to compare and distinguish the two herbs and to identify their potential characteristic markers. Then, an HPLC method was established for quality evaluation.@*RESULTS@#A total of 93 constituents are identified, including 54 phenolic acids, 35 flavonoids, two saccharides, one phenolic acid glycoside, and one other constituent, of which 67 were identified in B. riparia and B. megacephala for the first time. CPR indicates that B. riparia and B. megacephala samples can be distinguished from each other based on the LC-MS data. The isochlorogenic acid A to cryptochlorogenic acid peak area ratio calculated from the HPLC chromatograms was proposed as a differentiation index for distinguishing and quality control of B. riparia and B. megacephala.@*CONCLUSION@#This study demonstrates significant differences between B. riparia and B. megacephala in terms of chemical composition. The results provide a rapid and simple strategy for the comparison and evaluation of the quality of B. riparia and B. megacephala.
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A patient with fever, chills, and pancytopenia as major clinical manifestations was presented. To investigate the cause, the patient’s peripheral blood was collected for pathogen screening using metagenomic next - generation sequencing (mNGS). The DNA sequence of Leishmania donovani was detected, and Leishmania amastigotes were found in bone marrow smears using microscopy. The case was therefore definitively diagnosed as visceral leishmaniasis, and was cured and discharged from hospital following treatment with liposomal amphotericin B for 14 days. This is the first imported case of visceral leishmaniasis since the founding of Shenzhen City in 1979.
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Objective:To explore the effect of multidisciplinary collaborative intervention under hospital elder life program (HELP) on improvement of craniocerebral tumor elderly patients′ delirium prevention, physical and psychological status in ICU.Methods:Totally 89 craniocerebral tumor elderly patients undergoing craniocerebral tumor surgery under general anesthesia in ICU from Guangzhou Red Cross Hospital were selected as the research objects. 45 patients treated from January 2019 to January 2020 were set as the control group and given routine nursing intervention, and 44 patients treated from February 2020 to January 2021 were set as the observation group and given multidisciplinary collaborative intervention under HELP theory. The incidence of delirium, physiological, psychological recovery and complications during ICU stay were compared between the two groups before and after intervention.Results:Before intervention, there was no significant difference in the scores of various indexes between the observation group and the control group ( P>0.05). After the intervention, the mean arterial pressure, heart rate, intracranial pressure, SaO 2 and the score of modified Barthel index in the observation group were (92.15 ± 7.08) mmHg (1 mmHg=0.133kPa), (77.58 ± 3.68) times/min, (114.84 ± 10.35) mmH 2O (1 mmH 2O=0.009 8 kPa), 0.95 ± 0.04 and (80.21 ± 9.42) points, and those in the control group were (96.44 ± 7.15) mmHg, (74.29 ± 3.29) times/min, (136.28 ± 10.24) mmH 2O, 0.90 ± 0.05 and (62.44 ± 8.15) points, and there were statistically significant differences between two groups ( t values were 2.84-9.82, all P<0.01). After the intervention, scores of critical illness nutritional risk, ICU delirium screening, mental state and sleep disorder in the observation group were (4.79 ± 0.38), (1.27 ± 0.21), (43.24 ± 3.27) and (18.44 ± 2.17) points, those in the control group were (4.18 ± 0.37), (2.07 ± 0.30), (40.05 ± 3.21) and (20.14 ± 2.18) points, there were significant differences between two groups ( t values were 3.22-14.60, all P<0.01). After the intervention, the ICU stay time and the first time out of bed time in the observation group were (6.44 ± 0.52) d and (1.74 ± 0.32) d, which were statistically significantly lower than (7.69 ± 0.54) d and (2.43 ± 0.24) d in the control group ( t=11.12, 11.53, both P<0.01). After the intervention, the incidence of delirium in the observation group was 0, which was statistically significantly lower than 18.18% (8/45) in the control group ( χ2=8.99, P<0.01). Conclusions:Multidisciplinary collaborative intervention under HELP theory can effectively reduce the incidence of delirium, improve their physiological and psychological status, improve the quality of life of elderly patients after craniocerebral tumor surgery under general anesthesia.
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Objective To investigate the epidemic tendency and drug resistance of common pathogenic bacteria in the patients with infectious diarrhea,and then provide scientific evidence for the treatment of bacterial diarrhea.Methods The feces specimens were collected from 12 156 patients with infectious diarrhea in our hospital during April 1,2012 and October 31,2017.Then,they were cultured,and the obtained bacteria were isolated and identified by the Vitek 2 Compact system and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS).The serotype and drug resistance of the obtained bacteria were analyzed by the agglutination test and K-B disk diffnsion method,respectively.Results A total of 1 218 strains (10.02％,1 218/12 156) of pathogenic bacteria were isolated from 12 156 feces specimens,including 926 (7.62％,926/12 156) strains of Vibrio,96 (0.79％,96/12 156) strains of Aeromonas,178 (1.46％,178/12 156) strains of Salmonella and 18 (0.15％,18/12 156) strains of Shigella.The detection rates of pathogenic bacteria per year were 9.2％,11.9％,13.4％,7.0％,11.3％ and 7.2％,respectively,from 2012 to 2017.The detection rate of Shigella was low,but it had a high resistance to ampicillin and compound sulfamethoxazole (SMZ-TMP).Other pathogenic bacteria were more sensitive to SMZ-TMP,ceftriaxone,aztreonam,gentamycin and quinolones except ampicillin.Conclusion The main pathogenic bacterium in the patients with infectious diarrhea is Vibrio,and Shigella has the highest resistance to most drugs.The overall infection tendency is sporadic.It is necessary to strengthen the monitoring of pathogenic bacteria and their drug resistance in the patients with infectious diarrhea.
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Objective To study the target setup margin and dose evaluation for cervical cancer patients with volume-modulated arc therapy in the off-line adaptive radiation therapy (off-line ART),Methods A total of fifty patients with cervical cancer were randomly divided into test group and control group.Cone beam CT scanning was performed twice a week,the setup errors in directions of LR,AP and CC were recorded in the whole treatment process.The target setup formula was used to calculate the new CTV-PTV setup margin.At the same time,the setup error was returned to planning isocenter (ISO).For the control group,the dose was recalculated on the basis of the original PTV after considering ISO shift.For the test group,the dose was also recalculated after the new extended boundary of the target.The dosimetric parameters of CTV and organs at risk (OAR) were evaluated between two groups after dose recalculation.Results According to the target setup formula,extended boundaries of CTV in the direction of LR,AP,CC were 0.45,0.46 and 0.82 cm,respectively.The test group increased in CTV with D100％ and D95％ (t =-8.16,-6.73,P ＜0.05) and decreased in femoral head with V40,V30 and D (t=3.14,-9.52,-7.48,P＜0.05) than the control group.The test group decreased in the pelvis with V34 and D than control group (t =10.14,-9.38,P ＜0.05).Conclusions The CTV-PTV setup margin and the dose of OAR were effectively reduced,and the coverage of target area was extended when the off-line ART technology was conducted in the volume-modulated arc therapy for cervical cancer.
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Objective To study on virulence characteristics and multilocus sequence type of Vibrio parahaemolyticus isolated from clinic in Beijing Tongren hospital.Methods Total 152 strains of Vibrio parahaemolyticus isolates were collected from diarrheal patients of outpatients in Beijing Tongren Hospital,Capital Medical University from 2009 to 2011.PCR was used to detect hemolysin gene thermo stable direct themolysin gene (tdh),TDH-related hemolysin gene (trh),type Ⅲ secretion system 2 (T3SS2α,T3SS2β)and systematic functional gene (toxRS/new,orf8) for pandemic 03∶ K6 clone and its derivatives.The genetic features of these strains were determined by multilocus sequence typing (MLST).Results 96％ (146/152) VP harbored tdh gene,2％ (3/152) VP harbored trh gene and 100％ (152/152) VP harbored T3SS2 gene.In this study there were 107 pandemic strains (both tdh and toxRS/new positive and trh negative),38 pathogenic strains (tdh positive and/or trh positive) and 6 nonpathogenic strains (both tdh and trh negative).All nonpathogenic strains harbored systematic functional gene (toxRS/new,orf8).Only one pathogenic strains harbored orf8 gene.One clone harbored all virulence gene.In this study there were 16 sequence types,and ST3 is the pandemic sequence type,including 113 strains,and four new sequence types were found.Conclusions In this study more than 90％ Vibrio haemolyticus harbored tdh gene and ST3 was the pandemic sequence type in Beijing.One can get bacterial pathogenic charateristic and population genetics information by virulence gene testing and MLST.
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Objective To study the clinical application of the ITS and β-tubulin gene regions in identification of Aspergillus spp. Methods One hundred and twenty-four Aspergillus strains that isolated from fungal rhino-sinusitis specimens were collected in Beijing Tongren Hospital, Capital Medical University from July 2007 to January 2010. They were identified by morphological and molecular methods. The first one included traditional culture, slide culture, and microscopic examination after lactophenol cotton blue stain and KOH digestion. The second one was amplifying and sequencing the part of ITS and β-tubulin gene and aligned all the sequences in the GenBank, European Molecular Biology Laboratory nucleotide sequence database, and DNA Data Bank of Japan. Results Of the 56 Aspergillus flavus identified by morphological features, fifty-five isolates were identified as Aspergillus flavus and 1 isolates was Aspergillus parasiticus by the ITS and β-tubulin gene region sequence analysis. In the 37 Aspergillus fumigatus identified by morphological method, and all the 37 isolates were identified as species complex of Aspergillus fumigatus by the ITS region sequence analysis, but through the sequence analysis of β-tubulin gene region, thirty-five isolates were identified as Aspergillus. fumigatus and 2 were Aspergillus lentulus. Twenty-one isolates were identified as Aspergillus versicolor by morphological method, but 16 of them were identified as Aspergillus. versicolor and 5 can not be identified to species level by the ITS region sequence. And by comparative-sequence analysis of β-tubulin gene region, the 5 isolates were identified as Aspergillus sydowii,the other 16 isolates were Aspergillus. versilcolor. Ten isolates were identified as Aspergillus nidulans by morphological features, the ITS and β-tubulin gene region sequence analysis. Conclusions β-tubulin gene sequencing is more suitable for identifying Aspergillus, and could identify Aspergillus spp. to species level Sequences of ITS region could only identify Aspergillus spp. to species complex.
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Objective To study the genotypic and biological characteristics of catheter-related MRSE isolates and to further provide information for the diagnosis and prevention of catheter-related bloodstream infection. Methods Thirty strains of catheter-related MRSE isolates were collected from venosus blood and whole blood of 30 inpatients including 20 males and 10 females from Beijing Tongren Hospital, Capital Medical University from January 2006 to December 2009. The genetic features of these strains were determined by MLST. PCR was used to detect the icoA gene (encoding the polysaccharide intercellular adhesion associated with pathogenicity), and the antimicrobial susceptibility test was detected by disc diffusion test. Results A total of 15 STs were obtained from 30 strains ST259, ST20, ST2 and ST235 were common clones obtained from 17 strains. Four novel STs were found and uploaded to the MLST database (http://www. mlst. net), including ST259 (6 strains), ST260 (1 strain), ST261 (1 strain) and ST262 (1 strain). The ST259 was the dominant clone of catheter-related MRSE isolates in this hospital, and 3 strains carrying icaA gene were detected in this study. Conclusion Some ST259 isolates express high pathogenesis among the four novel STs, which may make them as the pandemic strains in nosocomial infection, and this would increase the difficulty of the prevention and control of nosocomial infection.
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Objective To study the mechanism of the resistance in Acinetobacter baumannii to common antibiotics.Methods Bacterial susceptibility test to ?-lactamatic antibiotics,quinolones,aminogiycosids were done by the Kirby-Bauer method and agar dilution method for 35 isolates.Penicillin-beta-lactamase,AmpCs,Metallo-beta-lactamase,ESBLs were detected by iodine-starch test,3-dimension test,microbiology sensitivity synergic test,disc agar diffusion method respectively.Outer membrane protein was analyzed by SDS-PAGE.Accumulation of ciprofloxacin was determined by direct Fluorescence method.The gene of Tem-1,aac-4 and gyrA were amplified by PCR while the gyrA was sequenced.Results 28 isolates were multi-resistant to common antibiotics in 35 isolates.16 isolates produced Penicillinase,10 isolates produced Cephalosporinase,2 isolates produced metal-beta-lactamase,3 isolates produced ESBLs.The analysis of outer membrane proteins showed that a protein of 29kD disappeared and 26kD protein enhanced in resistant isolates.The accumulation of ciprofloxacin in resistant isolates decreased.After treatment with NaN_3,the drug uptake increased to the normal level.Most of [QX(Y8]Tem-1 gene were positive except 2 drug resistant and 3 sensitive isolates.All of [QX(Y8]aac-4 were negative while gyrA were positive.DNA sequencing analysis revealed there had point mutation in the gyrA gene.Conclusion Beta-lactamase,active drug efflux,outer membrane protein permeability decreasement and gene mutation were the factors contributing to the antibiotics resistance of Abaumannii.
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Objective To study the effects of using the polysiloxane impression material in the repair of the precise attachment.Method Using the Rapid polysiloxane impression material to make 37 work impressions,29 un-work impressions were made by alginate impression material.Results All the work impressions were eligible while there were 4 un-work impressions not eligible at the first time. Conclusion The effects of using the polysiloxane impression material in the repair of the precise attachment is satisfactory.
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Objective To explore a rapid method for classification of microorganisms.Methods The electrophorese fingerprinting, direct sequence of 16S rDNA and 16S-23S rDNA ISR after PCR, multiplex PCR for 16S rDNA and antibiotic resistance genes, were utilized to explore fast approaches of extracting total DNA from different clinical specimens.Results The specific 16S-23S rDNA ISR fingerprinting fragments were shown on the genus or species level in bacteria and fungi.So fingerprinting can be used to identify pathogenic microorganisms, to differentiate the evolution relations or to set the phylogenetic tree by comparing their DNA banding patterns with those of standard strains (NCCLS). Multiplex PCR was able to examine the special genes of genus or species, mecA gene, TEM, SHV and CTX gene in staphylococcus and ESBLs(E.coli or K.pneumoniae) at the same time.Conclusion The part of 16S rDNA sequencing and 16S-23S rDNA ISR genotypes by gel electrophoreses were useful for bacterial species identification in addition, it was clearly more rapid and accurate than culture technique, and the large numbers of strains can easily be examined.Multiplex PCR could provide a good method for identification of microorganisms and analysis of antibiotic resistance at the same time.